OBJECTIVE: To study the long-term changes at donor sites and safety implications for donor eyes used for harvesting tissue for autologous and living-related donor limbal transplants. DESIGN: Retrospective, observational, consecutive case series. PARTICIPANTS: We examined 50 donor sites of limbal tissue belonging to 25 healthy eyes (23 human subjects). METHODS: The corneas and limbus of donor eyes were assessed for symptoms and visual acuity and examined by slit-lamp biomicroscopy and in vivo confocal microscopy with particular emphasis on the donor sites and central cornea. MAIN OUTCOME MEASURES: In the donor eyes, we assessed visual acuity, persistence of symptoms, stability of the corneal epithelium, and the clinical and microscopic changes that occurred at the donor sites. RESULTS: Mean follow-up was 41±38 months (median, 24; range, 3-127). All eyes had symptoms of ocular discomfort up to 4 weeks postoperatively and remained asymptomatic thereafter. No patient reported subjective reduction in visual acuity. Mean best-corrected visual acuity (logarithm of the minimum angle of resolution fraction) preoperatively was 0.076±0.19 and postoperatively was 0.09±0.17 (P = 0.57). All donor sites showed re-epithelialization of the peripheral denuded limbus within 2 weeks. Observed complications were filamentary keratitis and subconjunctival hemorrhage in 4 eyes. In vivo confocal microscopy confirmed that the central corneal epithelium remained normal in all eyes. The re-epithelialized donor site was covered with conjunctival epithelium in 17 sites of 10 eyes and with corneal epithelium in 7 sites of 5 eyes. CONCLUSIONS: Limbal donation of 2 clock-hours of the superior and inferior limbus with 3×3 mm of adjacent conjunctiva was a safe procedure in this group of patients, demonstrating stable vision and an intact corneal epithelium during the follow up period. Donor sites can be re-epithelized by multiple layers of either corneal or conjunctival epithelium and is associated with deep stromal scarring.
OBJECTIVE: To study the long-term changes at donor sites and safety implications for donor eyes used for harvesting tissue for autologous and living-related donor limbal transplants. DESIGN: Retrospective, observational, consecutive case series. PARTICIPANTS: We examined 50 donor sites of limbal tissue belonging to 25 healthy eyes (23 human subjects). METHODS: The corneas and limbus of donor eyes were assessed for symptoms and visual acuity and examined by slit-lamp biomicroscopy and in vivo confocal microscopy with particular emphasis on the donor sites and central cornea. MAIN OUTCOME MEASURES: In the donor eyes, we assessed visual acuity, persistence of symptoms, stability of the corneal epithelium, and the clinical and microscopic changes that occurred at the donor sites. RESULTS: Mean follow-up was 41±38 months (median, 24; range, 3-127). All eyes had symptoms of ocular discomfort up to 4 weeks postoperatively and remained asymptomatic thereafter. No patient reported subjective reduction in visual acuity. Mean best-corrected visual acuity (logarithm of the minimum angle of resolution fraction) preoperatively was 0.076±0.19 and postoperatively was 0.09±0.17 (P = 0.57). All donor sites showed re-epithelialization of the peripheral denuded limbus within 2 weeks. Observed complications were filamentary keratitis and subconjunctival hemorrhage in 4 eyes. In vivo confocal microscopy confirmed that the central corneal epithelium remained normal in all eyes. The re-epithelialized donor site was covered with conjunctival epithelium in 17 sites of 10 eyes and with corneal epithelium in 7 sites of 5 eyes. CONCLUSIONS: Limbal donation of 2 clock-hours of the superior and inferior limbus with 3×3 mm of adjacent conjunctiva was a safe procedure in this group of patients, demonstrating stable vision and an intact corneal epithelium during the follow up period. Donor sites can be re-epithelized by multiple layers of either corneal or conjunctival epithelium and is associated with deep stromal scarring.
Authors: O A Utheim; L Pasovic; S Raeder; J R Eidet; I G Fostad; A Sehic; B Roald; M F de la Paz; T Lyberg; D A Dartt; T P Utheim Journal: PLoS One Date: 2019-03-12 Impact factor: 3.240
Authors: Catherine J Jackson; Inger T Myklebust Ernø; Håkon Ringstad; Kim A Tønseth; Darlene A Dartt; Tor P Utheim Journal: Stem Cells Transl Med Date: 2019-12-04 Impact factor: 6.940
Authors: Fred K Chen; Samuel McLenachan; Michael Edel; Lyndon Da Cruz; Peter J Coffey; David A Mackey Journal: J Clin Med Date: 2014-12-19 Impact factor: 4.241